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espanolObjetivos: El sistema sanitario espanol ha sufrido muchos cambios como consecuencia de las politicas de austeridad llevadas a cabo durante la crisis economica, concretamente en lo que se refiere al gasto farmaceutico; medicamentos como los analgesicos, que previamente eran gratuitos para un sector de la poblacion, se han visto afectados por la aplicacion de un copago sobre el precio de venta. Por ello, nos planteamos identificar el efecto de la crisis economica en Espana sobre el gasto, prescripcion y consumo de analgesicos. Material y metodos: Se realizo un estudio observacional descriptivo transversal basado en programa de gestion de medicamentos del Servicio de Farmacia del Distrito Sanitario de Almeria, que incluye 18 centros de Atencion Primaria (AP). Se recogio informacion sociodemografica, prescripcion, gasto farmaceutico y consumo de opiaceos (N02A), antinflamatorios no esteroideos (AINE) (M01A) y analgesicos antipireticos (N02B) en 2008 y 2014. Se realizo un analisis descriptivo y comparativo del gasto, prescripcion y consumo entre 2008 y 2014, y entre centros de AP dependiendo de su ubicacion: rural o urbana, y con o sin necesidad de transformacion social, reportando diferencias de medias en terminos de aumento o disminucion porcentual. Para analizar las diferencias en el consumo entre 2008 y 2014 se llevaron a cabo pruebas parametricas (t-Student para datos apareados) y no parametricas (Test de Wilcoxon), segun la normalidad de las variables cuantitativas analizadas mediante el test de Kolmogorov-Smirnov. Resultados: Se incluyeron 18 centros de AP que daban cobertura a 291.024 usuarios en 2008 y 293.498 en 2014. La edad media de la poblacion fue 38,5 anos (DT: 4,7) en 2008 y 40,1 anos (DT: 4,5) en 2014. El gasto global de medicamentos disminuyo un 23 % en 2014, y el de analgesicos un 12 %. Sin embargo, el gasto de analgesicos supuso un aumento en el gasto general farmaceutico. La prescripcion y consumo de analgesicos tambien disminuyeron en 2014. A pesar de la disminucion generalizada de analgesicos, los opioides aumentaron el gasto, la prescripcion y el consumo. En el area rural, asi como en las zonas de necesidad de transformacion social, hubo un mayor aumento del consumo. Conclusiones: La crisis economica ha tenido un efecto negativo en la prescripcion, consumo y gasto de analgesicos. Sin embargo, se observa un cambio de perfil en el tratamiento, aumentando el gasto y el consumo de opiaceos respecto a otros analgesicos. EnglishObjective: The Spanish Health System has undergone many changes as a result of the austerity policies carried out during the spanish economic crisis, specifically in terms of pharmaceutical expenditure, since drugs such as analgesics, which were previously free of charge for a sector of the population, have been affected by the application of a co-payment on the sale price. Therefore, we intend to identify the effects of the economic crisis in Spain in the prescription, expenditure and use of analgesics. Method: A descriptive-cross-sectional study was carried out based on the drug program of the Pharmacy Service of the Health Area of Almeria, including 18 Primary Care centers. Information on the individual's sociodemographic status, prescription, use, and expenditure of analgesics for the treatment of pain such as Opioids (N02A), Nonsteroidal anti-inflammatory drugs (NSAID) (M01A), and Antipyretic analgesics (N02B) were collected in 2008 and 2014. We carried out a descriptive and comparative analyses of the expenditure, prescription, and use of analgesics between 2008 and 2014, and between Primary Care centers depending on the location of the centers: rural vs. urban areas, and deprivation vs. non-deprivation areas, reporting mean differences in terms of percentage increase or decrease. To analyze the differences in consumption between 2008 and 2014, parametric (t-Student for paired data) and non-parametric (Wilcoxon test) tests were performed depending on the normality of the quantitative variables, analyzed by the Kolmogorov-Smirnov test. Results: A total of 18 Primary Care centers were included, covering 291,024 users in 2008, and 293,498 in 2014. The mean age was 38.5 years (SD: 4.7) and 40.1 (SD: 4.57) in 2014. The global expenditure of drugs decreased by 23 % in 2014, and the expenditure of analgesics decreased by 12 %. However, the analgesics expenditure implied an increase in the global expenditure. The prescription and use of analgesics also decreased in 2014. However, opioids increased expenditure, the use and prescription. A higher increase in the use of analgesic was observed in the rural areas, as well as deprivation areas. Conclusions: The economic crisis has had a negative effect in the expenditure, use, and prescription of analgesics. However, a change in the treatment pain profile was observed, increasing the expenditure and use of opioids prescribed.

Gasto, prescripción y consumo de analgésicos antes y durante la crisis económica